Does Health First Colorado (Medicaid) Cover Dental Implants? My Guide to Dental Benefits in Colorado

Table of Contents

1. Introduction: My Experience Navigating Medicaid Dental Coverage

I’m going to be honest—when I lost a couple of teeth years ago, I was scared. I always thought dental implants were the best way to replace teeth. But I had Health First Colorado (that’s Colorado’s Medicaid), and I had no idea what was paid for. Were dental implants even something I could get, or was I just getting dentures? After a lot of searching, phone calls, and mistakes, I finally figured out how Medicaid dental benefits work here.

If you’re in the same spot—missing teeth, wondering if Medicaid will pay for implants—let me tell you what I learned. I’ll explain the benefits, real choices, and why some things get paid for and others don’t. This is your simple guide, based on my own story and tips from dentists like Dr. Joe Dental.

2. Understanding Health First Colorado Dental Benefits

Let’s start at the beginning. Health First Colorado is the real name for Medicaid in our state. It helps pay for health care for people with low incomes, older people, kids, people with disabilities, and some pregnant women. I signed up after my income fell, and it was so helpful—not just for doctor visits, but also for dental stuff.

Adult vs. Children’s Dental

This confused me at first: dental coverage is not the same for grown-ups and kids. If you are under 21, you get what they call EPSDT (Early and Periodic Screening, Diagnostic, and Treatment). This means kids and teens get most dental stuff covered. For adults like me, what is covered is less, but it’s better now than it used to be.

What Does “Dental Implants Covered by Medicaid” Even Mean?

Here’s where almost everyone gets mixed up. Many people (me too) read online that Medicaid pays for dental implants—so they ask, “Does Medicaid pay for implants in Colorado?” The answer is tricky. Sometimes there’s a small chance, but most of the time, you have to look at other choices.

3. The Short Answer: Are Dental Implants Covered?

After reading Health First Colorado rules, talking to my dentist, and calling the office that runs Medicaid, I found out the truth.

For most adults, Medicaid does NOT pay for dental implants in Colorado. That’s it.

Why is that? Dental implants are often seen as a “cosmetic” or “special” thing, not something you need for your health (unless it’s a really serious case—which I’ll talk about soon). Medicaid for grown-ups mostly covers basic cleanings and checks, fillings, or dentures, but not implants.

Still, there are some very rare times when they might pay for an implant, and I’ll talk about those below.

4. What’s Actually Covered for Adults Under Colorado Medicaid

When I went to the dentist, I got a small paper with a list of what is covered. Here’s what it said, made super simple:

What Medicaid DOES Cover (For Adults, 21+)

• Basic Care: Dental check-ups, cleanings, X-rays.
• Tooth Repair: Fillings for cavities.
• Tooth Removal: Simple tooth pulling.
• Dentures and Partial Dentures: New ones, fix-ups, and re-fitting them as your mouth changes.
• Root Canals: Most times just for front teeth or big problems.

What’s NOT Usually Covered

• Dental implants (almost always no)
• Teeth whitening, veneers or anything for looks
• Braces, unless you can really show it’s needed for your health
• Any fancy fake teeth besides simple dentures

Yearly Spending Limit

I found out about this fast. Since July 1, 2017, Colorado added some things for grown-ups, but they set a dollar limit per year. Last I checked, it was around $1,500 a year for dental stuff. So if you need lots of work, you could hit your cap pretty quick.

5. Dental Implant Coverage for Children and Special Cases

Now you might be thinking, “So adults can’t get them—what about kids, or special reasons?” Good question. Here’s what I learned:

For Children (Under 21)

If your child has Medicaid in Colorado, you get a bit more help. Under EPSDT, Medicaid has to pay for “medically needed” dental care. But— and this is a BIG deal—implants are hardly ever given the OK unless:

• There’s a bad accident (like a face injury)
• The child was born missing teeth
• Dentures or bridges won’t work at all
• All other ways have tried and failed

Even then, there’s a ton of paperwork. The dentist has to prove an implant is the ONLY way.

Special Cases for Adults

This is super rare, but I’ve heard of times when adults got Medicaid to pay for an implant after cancer surgery or a huge accident. You need lots of proof from your doctors and have to show it’s needed for your health (like keeping your jaws working after a tumor). You need an OK from Medicaid first, and honestly, most requests are turned down.

6. Alternatives to Dental Implants Covered by Medicaid

Once I learned implants were probably a no from Medicaid, I wanted to find out what tooth replacements were paid for in Colorado.

Full and Partial Dentures

For most grown-ups, full or partial dentures are what Medicaid covers for missing teeth. After my teeth were pulled out, I got a full set of dentures. They took a little getting used to, but now they work fine. Medicaid pays for a new set every so often, plus repairs or changes if your mouth changes.

You can learn about the steps for making good dentures at removable denture lab.

Dental Bridges

Bridges fill in missing teeth by attaching to the teeth next to the gap. But for adults on Colorado Medicaid, bridges are hardly ever paid for, unless there’s a really good reason (like if you lost a front tooth and a partial won’t work).

Tooth Removal

Pulling teeth is always paid for when you have pain, infection, or a bad tooth. I had several done, and I didn’t have to pay anything.

Keeping Your Expectations Real

Dentures don’t feel like real teeth and aren’t as good as implants. But for most people with Medicaid, they are the main, covered, working option. With a good fit, some practice, and a dentist who helps you adjust them, you can eat and smile almost like before.

7. Finding a Health First Colorado Dental Provider

The next hard part isn’t just knowing what’s paid for—it’s finding a dentist who takes Medicaid and understands the paperwork.

How to Find a Medicaid Dentist in Colorado

Here’s how I did it:

• Health First Colorado Website: Their provider search lets you find dentists nearby who take Medicaid.
• Call Clinics Nearby: Community health centers and Federally Qualified Health Centers (FQHCs) usually take Medicaid. In places like Denver, Aurora, Colorado Springs, and Pueblo, you’ll find some options.
• University of Colorado Dental School: Students, watched by real dentists, do dental work for Medicaid at lower costs.

Want to know about dental materials or lab-made teeth? Check out a dental ceramics lab to learn about what they use, even if you can’t get implants from Medicaid.

Always Double Check

Before you go in, always:

• Make sure the dentist is taking new Medicaid patients
• Confirm they cover the work you need
• See if you need special approval for the dental work (especially for anything not basic)

Getting Approval

For anything beyond cleanings and fillings, your dentist has to send in forms for approval. If you ever talk about implants, get ready for a long wait and probably a no.

8. What to Do If Dental Implants Aren’t Covered

I was bummed when I learned Medicaid didn’t pay for dental implants. But I kept asking around and doing research, and here’s what I found if you want more choices:

Community Clinics & Federally Qualified Health Centers

These clinics help people with low incomes. If you can’t get what you want through Medicaid, you might pay less here. In towns like Grand Junction and others, there are good clinics for dental work.

Dental Schools

The University of Colorado Dental School lets students, with a dentist watching, do all kinds of dental work—including sometimes implants—for less money. Good if you need something that’s not paid for by Medicaid.

Charities and Dental Help Groups

Groups like Dental Lifeline Network and other local charities sometimes help pay for expensive dental care. Just know, lots of people are on the wait list.

Making Payments

Some private dentists let you pay in steps if you want an implant. This can help if you really want an implant and can pay a little each month.

Dental Discount Plans

These plans are not insurance, but if you join, you get lower prices for things like implants or bridges. A friend of mine saved a lot on a partial denture this way.

If you want to know the price of implants without Medicaid, look at implant cost.

9. Real Life: Lessons Learned Along the Way

The biggest lesson I learned is that knowing the rules helps. If I knew about Medicaid’s dental coverage earlier, I wouldn’t have chased something I couldn’t get. I also learned to keep asking questions and to speak up for myself.

Here are a few things I learned:

• Get your treatment plan in writing. This way, you know what is and isn’t covered.
• Don’t ignore your mouth. Even if you can’t get the best thing, doing basic dental care helps keep the rest of your teeth healthy.
• Be open to choices. My dentures took some getting used to, but after a while, I felt better and could eat and smile again.
• Keep asking questions. Coverage changes, funding goes up or down, and a new option might come along in the future.

If you’re looking into special fake teeth, learning about choices from a zirconia dental lab can help, even if you might have to pay later.

10. Conclusion: Knowing Your Dental Care Options in Colorado

So here’s what I found out: In my experience—and from talking to dentists like Dr. Joe Dental—Health First Colorado almost never pays for dental implants for grown-ups. There are some rare times, but they need a mountain of paperwork and most are turned down. For most people, Medicaid gives good basic help: cleanings, fillings, pulling teeth, and dentures.

If you live in Colorado, use what you have. Keep up with check-ups and cleanings, don’t wait too long if you have tooth pain, and be realistic about what Medicaid covers. If you really want implants and can pay, check out dental schools, payment plans, or community dental clinics.

At the end of the day, the most important thing is keeping your mouth healthy and pain-free, and getting the best result you can with what’s paid for. Reach out to a Medicaid dental provider or the Colorado Medicaid office if you want advice just for you.

Your smile matters. Medicaid may have limits, but you can always look for answers and take care of yourself. That’s what I learned—and I hope my story helps you feel a bit more sure about your own dental care journey.